Suicide and psychiatric services.
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Community Psychiatry↗
Biomedical subjects
G Lewis
Publications and source records attributed to G Lewis.
Mechanical properties of vacuum-mixed acrylic bone cement.
The thrust of the present work was the experimental determination of the uniaxial static compressive and fully reversed tension-compression fatigue properties of CMW 3 acrylic bone cement whose constituents were mixed in a proprietary chamber while simultaneously subjected to a vacuum. Selected indices of performance in this material are: mean static compressive strength, 81.4 MPa; mean compressive modulus of elasticity, 1.95 GPa; endurance limit, 8.1 MPa; and characteristic fatigue life (using a three-parameter Weibull fit to the fatigue test data obtained at a stress of +/- 10 MPa), 238,712 cycles. The difficulties in comparing results obtained using different cement formulations, preparation conditions, and test conditions are detailed. With this in mind, it is suggested that the present results are within the range of values reported by previous workers for other formulations mixed using a variety of methods. The clinical significance of the present results is discussed.
Acrylates↗
Effect of methylene blue on the fracture toughness of acrylic bone cement.
It has been advocated that the use of contrast acrylic bone cement (namely, a cement in which a suitable additive is included) for the fixation of a cemented arthroplasty will facilitate its revision (should this be necessary). It is useful, therefore, to determine the extent to which each of the relevant mechanical properties of the cement is affected by the presence of such an additive. It is shown, in the present work, that the addition of one contrast agent (an aqueous methylene blue solution) to a cement has no statistically significant effect on its mode-I plane-strain fracture toughness. This strengthens the case for the use of contrast cement for the aforementioned application.
Acrylates↗
Are cities bad for your mental health?
A study was conducted using data from the Health and Lifestyle Survey, a population based community survey of England, Wales and Scotland in which psychiatric morbidity was assessed using the General Health Questionnaire. An association was found between urban residence and the prevalence of psychiatric morbidity (odds ratio 1.54, 95% CI 1.32-1.80) which persisted after adjustment for various confounding factors (odds ratio 1.34, 95% CI 1.13-1.58). The discussion mentions the need for further study into the psychologically harmful elements of urban life.
Confidence Intervals↗
Assessing psychiatric disorder with a human interviewer or a computer.
OBJECTIVE: To compare a self administered computerised assessment of neurotic psychiatric disorder (psychiatric morbidity) with an identical assessment administered by a human interviewer. In particular, to discover whether a computerised assessment overestimates or underestimates the prevalence of psychiatric morbidity in relation to a human interviewer. SETTING: A health centre in south east London, UK. SUBJECTS: A non-consecutive series of health centre attenders. Complete data were available on 92 subjects. DESIGN: All subjects received both assessments on the same occasion but were randomised to receive either the computerised assessment first or the human interview first. RESULTS: The mean total score on the assessment was the same for both methods of administration; computer 8.77 v human 8.69 (95% confidence interval for difference -0.70, 0.87). The correlation between the human and interviewer assessments was 0.91. CONCLUSION: Self administered computerised assessments are valid, unbiased measures of psychiatric morbidity. In addition to their use as a research tool, they have potential uses in primary care including screening for psychiatric morbidity and in forming the basis for clinical guidelines.
Adult↗
Religious identity and comfort beliefs in three groups of psychiatric patients and a group of medical controls.
In order to assess the religious beliefs and practices of psychiatric patients, a self-report questionnaire was developed. The questionnaire was administered to 73 psychiatric patients and 25 non-psychiatric controls. Older age, membership of an ethnic minority and the presence of psychiatric disorder were all significantly associated with higher scores on the questionnaire. Psychotic subjects obtained the highest scores whilst those of depressed and parasuicide subjects were intermediate between those of the control and the psychotic groups. These results emphasise the importance of religion for many patients with common psychiatric problems. Specialist religious help may be of value in the management of such problems.
Adolescent↗
The ankle joint prosthetic replacement: clinical performance and research challenges.
This article presents an up-to-date summary of ankle joint biomechanics and various aspects relevant to the endoprosthetic replacement of this joint (specifically, the tibiotalar articulation) when indicated. These aspects are: the design requirements, choice of materials, and clinical studies involving various designs. The reasons for the disappointing in vivo performance of most ankle implants, to date, are suggested and areas for research and development, aimed at introducing a new generation of these implants, are identified.
Ankle Joint↗
Psychiatric morbidity in primary health care in Santiago, Chile. Preliminary findings.
BACKGROUND: The aims were to determine the prevalence of psychiatric morbidity among primary care attenders in a poor suburb of Santiago and to study the relationship with health service use. METHOD: A cross-sectional survey was made of 163 consecutive attenders to a primary care clinic. RESULTS: Eleven per cent of the sample gave a psychological reason for consultation and the prevalence of psychiatric morbidity was 53%, defined using the revised Clinical Interview Schedule. Women and those of lower socio-economic status were at higher risk. Physicians recognised 14% of the psychiatric morbidity. Attenders with psychiatric morbidity consulted more frequently. CONCLUSIONS: There is a need to improve the recognition and management of psychiatric morbidity in primary care in Chile and other less developed countries. This could lead to the more efficient use of scarce health care resources in primary care.
Adult↗
A parametric finite element analysis study of the stresses in an endosseous implant.
The finite element analysis method was used to obtain the stresses in the various structures in an endosseous implant-contiguous bone construct using a two-dimensional idealization. The results were obtained as a function of the materials used for the post and the crown of the implant. It is shown that these stresses are critically dependent on the post material (for a given crown material). The clinical significance of the results is discussed.
Aluminum Oxide↗
Use of enzyme-linked immunosorbent assay (ELISA) for detection and quantification of monoclonal antibodies.
The thrust of the present work is the demonstration of the feasibility of using an enzyme-linked immunosorbent assay (ELISA) for the detection and quantification of a monoclonal antibody human serum. The antibodies used, 7E3 and D3GP3, have been proposed as platelet receptor blockers, being directed specifically against the platelet membrane receptors (glycoprotein IIb/IIIa) and thus of significance in the management of patients at a very hgih risk of thrombotic occlusion. It is shown that 7E3 is more easily adsorbed than D3GP3 and hence has a higher potential for the stated application.
Antibodies, Monoclonal↗
Apolipoprotein E-epsilon 4 allele and Alzheimer's disease.
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Adult↗
Schizophrenia sans frontieres: concepts of schizophrenia among French and British psychiatrists.
OBJECTIVE: To compare the first admission rates for schizophrenia in England and France, and to compare the concept of schizophrenia held by practising British and French psychiatrists. DESIGN: Comparative study of incidence rates in England and France; and postal questionnaire survey of a sample of about 1 in 30 psychiatrists in the United Kingdom and in l'Aquitaine, France. SUBJECTS: All first admissions for schizophrenia to psychiatric hospitals in England and France 1973-82; 92 psychiatrists in the United Kingdom and 69 in France. MAIN OUTCOME MEASURES: Age adjusted first admission rates for schizophrenia between 1973-82; and opinions on the aetiology, diagnosis, and management of schizophrenia. RESULTS: First admission rates were much higher in France than in England before the age of 45, but lower after that age. Rates were falling in England over the 10 year period, while they were rising in France. In the questionnaire study English and French psychiatrists showed prominent differences of opinion for 31 out of 38 statements. The French sample did not diagnose schizophrenia after the age of 45 and endorsed psychoanalytical concepts. CONCLUSIONS: British and French psychiatrists use different diagnostic criteria and contrasting methods of treatment for schizophrenia. Differences in diagnostic criteria probably contribute towards the disparity in administrative incidence rates and time trends for schizophrenia in the two countries. Doctors in the European Community can now work in any country. Further work is needed to ensure psychiatrists are talking a common language.
Adolescent↗
Obstetric complications and schizophrenia.
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Female↗
Traumatic pancreatic pseudocysts.
Fifteen patients who developed pseudocysts following pancreatic trauma were evaluated to determine outcome in relation to the nature and site of pancreatic duct injury. Pseudocysts developed in eight patients operated on within 48 h of abdominal trauma and in seven who were initially treated conservatively. In none was duct injury diagnosed during initial management. Presentation was a median of 20 (range 8-360) days after injury. In 14 patients, pseudocysts (mean diameter 9 (range 3-16) cm) were confirmed by computed tomography or ultrasonography. Endoscopic retrograde pancreatography (ERP) demonstrated the site and severity of the duct injury in eight of 11 patients. Two patients with side duct injury on ERP were treated successfully without intervention. Pseudocysts arising from distal duct injuries (four patients) were treated by percutaneous aspiration or catheter drainage, although one patient required subsequent distal resection for recurrent pancreatitis caused by a pancreatic duct stricture. Three patients with duct injuries in the neck or body with pancreatic disruption underwent distal pancreatectomy. Proximal duct injuries with mature pseudocysts (three patients) were drained internally. Three patients had complicated pseudocysts (haemorrhage in one, sepsis in two) that necessitated emergency laparotomy and external drainage; one of these patients died from sepsis. These findings suggest that traumatic pancreatic pseudocysts that follow peripheral duct injury may resolve spontaneously, whereas those associated with distal duct injuries can be treated by percutaneous aspiration or catheter drainage. Proximal duct injuries, however, require surgical intervention using either resection or internal drainage, depending on the maturity of the cyst wall.
Adult↗
Electrochemical behavior of Ti-6Al-4V alloy in static biosimulating solutions.
The static general corrosion behavior of Ti-6Al-4V alloy specimens in three lactated Ringer's-based solutions was investigated using d.c. potentiodynamic, d.c. linear polarization resistance, and a.c. impedance techniques. A critical appraisal of the use of these techniques for the estimation of the corrosion rate of the material is presented. Whence it was shown that the presence of bovine serum in or decreasing the pH level of (to about 1) lactated Ringer's solution leads to an increase in the corrosion rate of the alloy (relative to that in lactated Ringer's solution, pH 6.25).
Alloys↗
Coeliac plexus block for chronic pain syndromes.
The purpose of this article is to familiarize the anaesthetist with the basic anatomy of the coeliac plexus; the techniques used to perform the procedure, its indications, complications and results in the management of chronic abdominal pain syndromes. Radiological, surgical and anaesthetic literature from the beginning of the century were reviewed. The main indication for neurolytic coeliac plexus block is intractable pain secondary to carcinoma of the pancreas or stomach. There appear to be theoretical advantages to techniques that result in spread of solution anterior to the aorta, such as the trans-aortic approach. These have not yet been demonstrated in any studies with large numbers of patients.
Abdominal Pain↗
The determination of absorption coefficients for measurement of carboxy-hemoglobin, oxy-hemoglobin, reduced hemoglobin, and met-hemoglobin in sheep using the IL482 CO-Oximeter.
The IL482 CO-Oximeter uses four wavelengths of visible light to analyze blood samples for the relative percentages of oxy-, carboxy-, reduced, and met-hemoglobin. In the analysis, the absorption at each of the wavelengths is multiplied by a matrix of four coefficients to derive the quantities of the four hemoglobin types. The normal settings of the CO-Oximeter coefficients are those for adult human hemoglobin. However, animal blood can be measured provided that the appropriate matrix of coefficients is available. Instrumentation Laboratory has provided sets of coefficients for several animal species. The company has also published a protocol for determining coefficients for other animal species. This protocol was examined using sheep hemoglobin-A blood and found to be inaccurate. The IL482 protocol is unsatisfactory because, if the initial error is large, successive iterations to determine the coefficient matrix through revision of the estimates of residual hemoglobin types do not converge. With sheep type-A hemoglobin, the use of human coefficients for the initial estimate gave a value of 6%, whereas, by chromatography, the carboxyhemoglobin (COHb) was 0.12% (i.e., a better initial estimate would be zero). When this was done, the final COHb estimate on "as-drawn" blood was within 1% of the COHb measured independently by gas chromatography. Revision of the protocol gave a markedly better accuracy, within 2% for COHb over the whole range when tested against mixtures of CO and O2 tonometered blood.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
The effect of zinc in the form of erythromycin-zinc complex (Zineryt lotion) and zinc acetate on metallothionein expression and distribution in hamster skin.
The occurrence of zinc-induced synthesis of metallothionein in skin after topical application of the anti-acne drug Zineryt lotion was investigated in hamster ears. The dinitrophenyl hapten-sandwich immunohistochemical method involving a monoclonal anti-metallothionein (MT) antibody (E9) was used to detect and localize zinc-binding MT in the 'treated' and untreated hamster skin. Atomic absorption spectrophotometry and dithizone histochemistry indicated that zinc penetrated the skin more readily, and accumulated more efficiently within the sebaceous glands, when applied to the skin surface as the organo-zinc complex, rather than as the inorganic zinc salt. MT and zinc had similar distributions in hamster skin exposed to the metal. Thus, MT immunoreactivity was especially intense in the sebaceous glands of Zineryt lotion-treated skin, with evidence of nuclear distribution in some cells. Zinc delivered to the sebaceous glands, and released from the organo-complex under the prevailing aqueous conditions, certainly induced MT synthesis; the cysteine-rich protein may protect the pilosebaceous units during the inflammatory phase of acne by scavenging generated oxyradical species.
Acetates↗